Online Reviews of Spinal Surgeons: Exploration of Trends by Affiliation

Study Design: Cross-sectional observational study. Objective: To determine whether online review volume and ratings for spine surgeons differ systematically by practice affiliation and specialty across third-party review platforms. Summary of Background Data: Patients increasingly consult online physician reviews when selecting a surgeon. Whether review accumulation on public platforms differs by practice model in spine surgery has not been established. Methods: We collected publicly available reviews for 466 spine surgeons (150 academic, 200 hospital-employed, and 116 private practice) across 10 US cities from Google Reviews, HealthGrades, and Vitals (November 2023 - March 2024). Primary outcomes were total review count and average star rating. Review counts were compared across affiliations using nonparametric tests with p values adjusted for multiple comparisons, and modeled with negative binomial regression to estimate count ratios adjusting for specialty and years in practice. Results: Academic surgeons had a mean of 74.2 total reviews (95% CI: 60.1–88.3) compared with 136.0 (118.3–153.7) for hospital-employed and 123.1 (104.4–141.8) for private practice surgeons ( P <0.001). After adjusting for specialty and years in practice, hospital-employed and private practice surgeons accumulated 1.71 (95% CI: 1.41–2.08) and 1.67 (1.34–2.08) times as many reviews as academic surgeons, respectively. Average ratings did not differ by affiliation ( P =0.12). Among 35,840 star ratings, academic surgeons had a higher 1-star proportion (12.2%) than the overall sample (9.4%, P <0.001). Conclusion: Academic spine surgeons accumulate fewer third-party reviews despite similar ratings. The elevated 1-star rate among academic surgeons is inconsistent with selective review removal. Review volume on public platforms may reflect institutional feedback infrastructure and referral pathways and may not reliably indicate clinical quality. Level of Evidence: Level III.